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术前 MRI 检查在年轻乳腺癌患者中的预后意义。

Prognostic significance of preoperative MRI findings in young patients with breast cancer.

机构信息

A.C. Camargo Cancer Center, Imaging Department, São Paulo, 01509-010, Brazil.

A.C. Camargo Cancer Center, Mastology Department, São Paulo, 01509-010, Brazil.

出版信息

Sci Rep. 2019 Feb 28;9(1):3106. doi: 10.1038/s41598-019-39629-w.

Abstract

The objective is to evaluate the prognostic value of preoperative magnetic resonance imaging (MRI) findings in breast cancer patients aged less than 40 years. This retrospective, single-center study evaluated 92 women aged <40 years who received a diagnosis of invasive breast carcinoma between 2008 and 2012. These patients underwent a breast MRI before treatment and follow-up at the same institution. Kaplan-Meier survival curves were used to analyze overall survival, with the log-rank test used to compare different groups. Cox regression analysis was used to estimate hazard ratios (HRs) with 95% confidence interval (95% CI) values. The mean age of the patients was 34 years (range: 25-39 years) and the mean tumor size was 3.9 cm in maximal dimension (range: 0.7-10.5 cm). Recurrence was observed in 21 (22.8%) patients and 15 (16.3%) patients did not survive during a mean follow-up period of 5.4 ± 1.9 years. MRI findings associated with worse overall survival included tumor size >5 cm (HR:5.404; 95% CI:1.922-15.198; p = 0.017), presence of non-mass enhancement (HR:3.730; 95% CI:1.274-10.922; p = 0.016) and multifocal tumor (HR:3.618; 95% CI:1.151-11.369; p = 0.028). Inconclusion, MRI findings that are suggestive of more extensive disease were associated with worse overall survival in young breast cancer patients.

摘要

目的在于评估年龄小于 40 岁的乳腺癌患者术前磁共振成像(MRI)发现的预后价值。这项回顾性、单中心研究纳入了 2008 年至 2012 年间诊断为浸润性乳腺癌且年龄小于 40 岁的 92 名女性患者。这些患者在治疗前及于同一机构进行随访时均接受了乳房 MRI 检查。采用 Kaplan-Meier 生存曲线分析总生存情况,对数秩检验用于比较不同组间的差异。采用 Cox 回归分析评估风险比(HR)及其 95%置信区间(95%CI)值。患者的平均年龄为 34 岁(范围:25-39 岁),最大径的平均肿瘤大小为 3.9cm(范围:0.7-10.5cm)。21 例(22.8%)患者出现复发,15 例(16.3%)患者在平均随访 5.4±1.9 年后死亡。与总生存较差相关的 MRI 发现包括肿瘤直径>5cm(HR:5.404;95%CI:1.922-15.198;p=0.017)、存在非肿块样强化(HR:3.730;95%CI:1.274-10.922;p=0.016)和多发病灶(HR:3.618;95%CI:1.151-11.369;p=0.028)。总之,提示疾病更广泛的 MRI 发现与年轻乳腺癌患者的总生存较差相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7553/6395807/e0078012740e/41598_2019_39629_Fig1_HTML.jpg

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